We asked last week’s interviewee some clinical questions to give you an inside look at her trade & help you understand your feelings.
Dear Footnotes,
I’m constantly worried something is wrong. I keep waking up in the middle of the night, thinking I’ve accidentally offended someone that day. Is this symptomatic of anxiety? How do I fix it?
Sincerely,
Molly
Clinical Psychologist:
It seems like you have some social anxiety trait whether you meet the criteria for a disorder or not. Fortunately, social anxiety is incredibly easy to work through! There’s really good evidence-based results through CBT (cognitive behavioural therapy) treatment for people with different social anxiety issues.
The first thing to do would be to develop an understanding where that fear is coming from – what are you actually scared of when you find yourself nervous to talk to other people? Is it fear of negative judgment? Are you worried about them seeing your hand shaking, or that you’re blushing?
After you figure that out, you will actually do different exposures which is basically when you force yourself to do silly things in front of people. You will realize that the world doesn’t end and that you can survive. You learn that you can cope even if people do think you’re silly.
In regard to not overthinking after conversations, we just try to create an understanding that this is an unhelpful thinking style then we can try to shift those thoughts. Effectively, we learn where they are coming from and then we understand how to change them. It’s all about understanding the foundations and try to shift negative thinking styles, which can eventually change overthinking even in the moment.
Overall, it’s all about completely reducing avoidance. Avoidance is huge in social anxiety – if you’re constantly avoiding social situations and chatting to people, it might give you relief in the short term, but you’re consistently maintaining that fear in the long term. Avoidance means you never giving yourself the option to learn that you can cope in that social situation, and it might not be as bad as you think it is. So, we would work on reducing the safety behaviours and avoidance, and increasing yourself advocacy in social situations.
FN: I feel like a lot people throw around the phrase… “I’ve got anxiety”, to the point that it’s almost become a buzzword. How do you know whether you’re actually suffering from anxiety, the kind that can actually cripple your day to day, versus that fleeting thought of, “I’m not good enough”?
A: Yeah, I understand what you mean. The stress response is incredibly normal, it comes from fear of a threat or feared situations. Everyone needs an optimal level of arousal to complete daily events, so it’s very normal that everyone gets stressed.
However, it’s when that stress becomes chronic and you’re constantly getting that heightened flight or fight reaction to things that shouldn’t make you feel that fear. When it’s daily occurrence and it’s having a clinical impact on you, because it’s impairing your ability to function in the work place or sleep, this is a problem.
The criteria for generalized anxiety disorder are limited to just overthinking and continually worrying. It’s actually about feeling like you have no control over that worrying and not being able to manage it. When it’s impacting your sleep, or making you really irritable, those are signs. But it’s also a pervasive feeling for a few weeks.
Do you have a question for our resident clinical psychologist? Email us at: hello@thefootnotes.com.au.
Who is she? She works in a private practice, that specializes in eating disorders and a range of other niche disorders. She sees a range of different presentations, from mood and anxiety disorders like depression, bipolar, OCD, to more specific phobias. Her full career story is here.